The kinematic and physiological pilot study on obstacle properties for young adults with visual and hearing impairments

The kinematic and physiological pilot study on obstacle properties for young adults with visual and hearing impairments | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The kinematic and physiological pilot study on obstacle properties for young adults with visual and hearing impairments Miura Misa, Kohzuki Masahiro, Goto Hiromitsu, Homma Midori，, Taku Harada This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4787024/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Individuals with visual and hearing impairments often experience a lower quality of life (QOL) and reduced physical motor functions due to restricted activity ranges. This reduction in physical activity can lead to overactivity of cardiac sympathetic nerves, increasing the risk of cardiovascular disease. However, the specific differences in physiological and kinematic responses due to the characteristics of visual and hearing impairments remain unclear. This pilot study aimed to investigate these differences in 34 university students using an orthostatic tolerance test and to analyze various parameters, including indicators of arteriosclerosis and physical motor functions. Participants were divided into three groups: healthy individuals, individuals with visual impairments, and individuals with hearing impairments. The results showed no significant differences in QOL and physical motor abilities between healthy and impaired individuals. However, distinct differences were observed in the orthostatic tolerance test based on the type of impairment. Associations between autonomic nervous system parameters and arteriosclerosis indicators were also identified in individuals with visual or hearing impairments. These findings highlight the necessity of addressing health risks specific to the type of impairment from a young age, suggesting the potential benefits of tailored preventive health programs. Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors visual impairment hearing impairment orthostatic tolerance test kinematic and physiological analysis preventive medicine Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 1. Introduction According to the World Health Organization (WHO), at least 2.2 billion people globally have near or distant vision impairments. Refractive errors and cataracts are the main causes of visual impairment and blindness. The prevalence of visual impairment worldwide is increasing, with 437.5 million visually impaired individuals reported in 2019, a 91.5% increase since 1990 1 . This increase is attributed to the aging population and disparities in access to medical services 2 . Hearing impairment can be caused by congenital factors, infections, noise exposure, aging, and ototoxic drug use. According to WHO reports, approximately 20% of the global population (over 1.5 billion people) have some form of hearing impairment, with 430 million experiencing impairments severe enough to affect daily life. Preventable causes of hearing impairment are particularly prevalent in low- and middle-income countries, where a significant proportion of affected individuals are children 3 . Individuals with visual and hearing impairments experience restricted physical activity levels and lower quality of life (QOL) owing to the nature of their impairments 4,5 . Furthermore, studies have shown that compared with healthy individuals, those with impairments have poorer physical fitness, including body composition, aerobic capacity, and balance function 6,7 . Additionally, decreased physical activity levels can lead to overactivity of the cardiac sympathetic nervous system, increasing the risk of cardiovascular disease and the incidence of comorbidities 8,9 . However, differences between young individuals with visual and hearing impairments and their healthy counterparts remain unclear. Analyzing autonomic nervous activity (HRV) through orthostatic tolerance tests provides a non-invasive and straightforward method to investigate differences based on impairment characteristics. Therefore, this study aimed to examine the differences arising from the characteristics of visual and hearing impairment in healthy individuals using orthostatic tolerance tests based on HRV frequency domain analysis. Additionally, this study included a physiokinetic analysis of arteriosclerosis indicators, QOL, and physical motor functions. 2. Materials and Methods Participants: A recent observational study included 34 university students aged > 20 years who did not engage in regular exercise and attended public facilities in Tsukuba City, Japan, between June 2019 and January 2023 (Fig. 1). The participants were divided into three groups (Table.1): the Healthy adult group (H group), consisting of 11 healthy individuals with no visual or hearing impairment; the Visual impairment group (VI group), consisting of 10 individuals with visual impairment (corrected visual acuity in both eyes below approximately 0.3); and the Hearing impairment group (HI group), consisting of 13 individuals with hearing impairment (hearing level in both ears above approximately 60 dB). Measurements were taken for limb muscle mass, body fat percentage, upper- and lower-limb muscle strength, balance ability, cardiac autonomic function, degree of arteriosclerosis, physical activity level, and QOL were measured. Each parameter was compared and analyzed among the groups. The exclusion criteria included individuals with acute coronary syndrome, such as unstable angina and musculoskeletal disorders under medical management, and those whom a physician deemed unsuitable for participation in this study based on medical evidence. The Ethics Committee of Tsukuba University of Technology approved the study protocol (approval number: 2019-02). The study was registered in the University Hospital Medical Network Clinical Trials Registry (Identifier UMIN000054763). This study was conducted in accordance with the principles of the Declaration of Helsinki. All the participants provided written informed consent to participate in the study. Method This is a cross-sectional study. We selected 34 participants who volunteered via poster announcements at our university and associated facilities and provided written consent to participate. Measurements included limb muscle mass, body fat percentage, upper and lower limb strength, balance ability, cardiac autonomic function, arterial stiffness, physical activity level, and Quality of Life (QOL). These parameters were compared between the groups. All participants were evaluated for physical exercise functionality, and a range of biochemical tests and QOL were compared. A Quality-of-Life assessment was conducted using a questionnaire survey (SF-8) along with body composition analysis. Study procedures. The study design is illustrated in (Figure 2). First, the participants underwent an orthostatic tolerance test after a 15-minute rest period. The orthostatic tolerance test was conducted as follows: the participants sat quietly for 2 min, stood up, and remained standing for another 2 min 10 . The laboratory temperature was maintained at 23°C. All the experiments were conducted during the same time (between 8:00 AM and 1:30 PM). The participants were instructed to refrain from vigorous exercise, eating, or consuming caffeinated beverages for 3 h before the experiment. Additionally, the participants were prohibited from consuming alcohol for 48 h prior to the experiment. Subsequently, measurements were taken for limb muscle mass, body fat percentage, upper- and lower-limb muscle strength, balance ability, cardiac autonomic function, degree of arteriosclerosis, physical activity level, and QOL were measured. Differences in each parameter were compared and analyzed among the groups. Sample size. The sample size was calculated using G*Power (Heinrich-Heine University, Düsseldorf, North Rhine-Westphalia, Germany). The number of study participants was based on a previous study in which HRV analysis was performed on university students with hearing loss [9,10]. Therefore, the target number of patients was 34 (α = 0.05, 1-β ＝ 0.95). Measurement of Heart Rate, Blood Pressure, and Autonomic Nervous System Activity The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate variability (HRV) indices, which indicate autonomic nervous system activity, were measured during orthostatic tolerance tests conducted before and after each session. Heart rate (HR) was measured using an electrocardiogram (ECG), and BP was measured using an automatic upper-arm blood pressure monitor. HRV indices were measured using the software program "Kiritsu-Meijin" (Crosswell, Yokohama, Japan) to evaluate autonomic reflexes during the orthostatic tolerance test 10 . The R-wave signals from the ECG were acquired at 1000 Hz, with arrhythmias and artifacts automatically detected and removed using the software. All ECG waveforms were stored in the software to ensure the accuracy of the preprocessed data. HRV indices were obtained from HR using modulus electromyography (MEM). MEM does not depend on stationary data and can evaluate autonomic nervous activity based on short-term R-R intervals, making it useful for assessing dynamic or phase changes in autonomic function during and after exercise 11-13 . The software provides reliable HRV analysis at intervals of at least 30 s. The average values for 1 min immediately before and after standing were used as seated values. The coefficient of variation (CVRR) of the R-R intervals was determined by dividing the standard deviation (SD) of the R-R interval by the mean (M) R-R interval. CVRR is used as an indicator of overall autonomic nervous system activity 14 . Frequency analysis was used to extract HF and LF 15 . HF is an indicator of parasympathetic activity, and the ratio of LF to HF (L/H) is an indicator of sympathetic activity 16-18 . Measurement of body composition, degree of arteriosclerosis, Physical activity levels, QOL Limb muscle mass and body fat percentage were measured using a body composition analyzer (Tanita Corporation MC-780A). Weight, skeletal muscle mass, and fat mass were measured. Additionally, height and physical activity data were obtained from their application forms 19 . Lower-limb muscle strength, balance, and explosiveness were assessed using a physical function analysis device (ZaRitz BM-220) 20 . The degree of arteriosclerosis was measured using an arteriosclerosis measuring device (NAS-1000, Nihon Kohden Corporation), which is a type of blood pressure monitor that automatically calculates the stiffness of the brachial artery and the degree of arteriosclerosis throughout the body 21 . Physical activity levels were obtained through interviews, and QOL was measured using a questionnaire survey (SF-8) 22,23 . Statistical analysis Data are expressed as means and standard deviation (SD). Statistical analyses were performed using SPSS software (version 21.0; SPSS Inc., Chicago, IL, USA). Data were evaluated using a two-way analysis of variance (ANOVA; session × time) with post hoc analysis employing a Student’s paired t-test between the pre- and post-intervention and between the sitting and standing positions, and a Bonferroni correction for multiple comparisons among the groups. The correlation between each HRV parameter and the API and AVI parameters was determined using Pearson's correlation coefficient. Statistical significance was accepted when the p-values were < 0.05. 3. Results No falls or adverse events occurred during the measurement procedures, indicating that the assessments were performed safely. The characteristics of the participants are summarized in Table 1. As shown in Figure 3, no significant differences were observed among the three groups in either PCS or MCS, which are indicators of QOL. There were no significant differences in HR, SBP, or DBP before and after the orthostatic tolerance test, nor were there any differences among the three groups (Table 2). In Figure 4, Graph (A) shows that the HR significantly changed when standing up among the three groups (P = 0.015). Furthermore, a significant difference was observed between the H group and HI group (P = 0.003). Graph (B) shows that the SBP did not change when standing among the three groups or when standing from the sitting position in all groups. In Figure 5, Graph (A) shows that CVRR significantly changed in the sitting position before and after the orthostatic tolerance test (P = 0.0178). Furthermore, a significant difference was observed between the VI group and HI group (P = 0.0265). Graph (B) shows that HF significantly changed in the sitting position before and after the orthostatic tolerance test between the H group and HI group and between the HI and VI groups (P = 0.0004). Graph (C) shows that L/H did not change before and after the orthostatic tolerance test or among the three groups. As shown in Figure 6, the results of the API measurements indicate that the standard value for the API is between 20 and 33. The average value for the HI group exceeded the standard range. A significant difference was observed between the H group and HI group (P = 0.013). The results of the AVI measurements indicated that the standard value for AVI was between 17 and 31. The average value for the HI group exceeded the standard range. A significant difference was observed between the H group and HI group (P = 0.045). No differences were observed among the three groups in terms of muscle strength, balance, or chair speed. In Figure 7, Graph (A) shows a significant correlation between CVRR and API in the VI group (r = -0.64; p = 0.04). Graph (B) shows a significant correlation between L/H and API (r = 0.57, p = 0.04). No differences were observed among the three groups in terms of muscle strength, balance, or chair speed. 4. Discussion This study is the first to investigate the physiokinetic characteristics and health risks in young individuals with visual and hearing impairments. Our findings indicate that while there are no significant differences in quality of life (QOL), body composition, or physical motor function between healthy individuals and those with visual or hearing impairments, distinct differences are observed in heart rate variability (HRV) and arteriosclerosis indicators obtained from the orthostatic tolerance test. The hypothesis that HRV is involved in arteriosclerosis and reflects differences in impairment at an early stage is supported by our results. Physical activity typically activates the sympathetic nervous system and inhibits parasympathetic activity 24,25 , which aligns with the findings in the healthy (H) and visually impaired (VI) groups. However, the hearing impaired (HI) group, shielded from noise, shows activation of parasympathetic nervous system activity even at rest 26 . This unique response likely contributes to the observed differences in arteriosclerosis indicators between the groups. The HI group's atherosclerosis index exceeding the standard value suggests that atherosclerosis progresses before any change in blood pressure 27,28 , highlighting the need for early interventions. Previous studies have noted that elderly individuals with sensory impairments tend to have lower physical activity levels, decreased physical motor function, and reduced QOL 29 , which are associated with a higher risk of lifestyle-related diseases such as arteriosclerosis 30 . Our study extends these findings to younger populations, suggesting that in environments where disability support is provided 31 , physical activity levels can be maintained, resulting in physical function and body composition comparable to healthy individuals of the same age. Consequently, no significant differences in QOL were observed among the groups. This study has some limitations. First, the sample size was limited to a single-center analysis. Second, participants did not undergo any intervention, which limits the ability to draw causal conclusions. Future studies should aim to include a larger sample size and extend the intervention period to validate these findings and explore the potential benefits of tailored preventive health programs for individuals with visual and hearing impairments. In conclusion, despite the small sample size, this study provides valuable insights into the physical function, body composition, and cardiac autonomic function of visually impaired, hearing impaired, and healthy young individuals. The results underscore the importance of early and tailored preventive rehabilitation based on specific disability characteristics to mitigate health risks and enhance social participation through increased physical activity. 5. Conclusions Despite the small sample size, this is the first study to investigate physical function, body composition, and cardiac autonomic function among visually impaired, hearing-impaired, and healthy cohorts. These results hold value beyond the prevention of diseases and care requirements for the visually and hearing-impaired and present substantial benefits for the social participation of disabled individuals through increased physical activity. This study highlights the potential effectiveness of tailored preventive rehabilitation based on specific disability characteristics. Declarations Supporting Information S1 table. Absolute and normalized values of HRV indices in the sitting position Institutional Review Board Statement The Ethics Committee of Tsukuba University of Technology approved the study protocol (approval number: 2019-02). The study was registered in the University Hospital Medical Network Clinical Trials Registry (Identifier UMIN000054763). Informed consent was obtained from all subjects involved in the study. Conflicts of Interest All authors have no conflicts of interest to disclose. Funding Misa Miura is currently receiving grants (21K11189, 23H03249) from JSPS KAKENHI. Author Contribution MM. and GH.; data curation, HM.; HT.; measurement, HS.; health management, HT.; supervision, MM.; writing and editing, KM.; supervision. Acknowledgement The authors thank all the participants who volunteered for this study. The authors also thank Li Jie for technical assistance. Data Availability Data is provided within the manuscript or supplementary information files． References . Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. The Lancet. Global health. 9, e144-e160 (2021). Steinmetz, J. D. et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. The Lancet Global Health. 9, e144-e160 (2021). Haile, L. M. et al. Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. The Lancet. 397, 996–1009 (2021). Chang, K. F. et al. 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Supplementary Files Table120240610.docx Table2.docx SupportingTable.docx figureledgend20240722.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4787024","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":344122326,"identity":"47a2577e-2214-467b-8b52-e530c782fd9f","order_by":0,"name":"Miura 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12:45:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2738668,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4787024/v1/fc24237f-b15a-4cef-9e67-2a0aefa0b962.pdf"},{"id":63832476,"identity":"df877d8d-018f-41d4-9d9d-0765a3de11f5","added_by":"auto","created_at":"2024-09-02 19:17:44","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":33493,"visible":true,"origin":"","legend":"","description":"","filename":"Table120240610.docx","url":"https://assets-eu.researchsquare.com/files/rs-4787024/v1/ad16018fddca03ffe4d839a1.docx"},{"id":63833140,"identity":"df39ab77-354b-41b3-a8b5-4973005afa2d","added_by":"auto","created_at":"2024-09-02 19:25:44","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":29215,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4787024/v1/ef4f20399d94750ef921efd4.docx"},{"id":63833141,"identity":"a5d64312-f87f-429b-91cb-8bbab6d3a483","added_by":"auto","created_at":"2024-09-02 19:25:44","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":17386,"visible":true,"origin":"","legend":"","description":"","filename":"SupportingTable.docx","url":"https://assets-eu.researchsquare.com/files/rs-4787024/v1/626e11fee750f33df5190213.docx"},{"id":63832485,"identity":"c918a235-66de-4f0d-8f20-2fd2364220ed","added_by":"auto","created_at":"2024-09-02 19:17:44","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":26067,"visible":true,"origin":"","legend":"","description":"","filename":"figureledgend20240722.docx","url":"https://assets-eu.researchsquare.com/files/rs-4787024/v1/53308d15c3f23d7f1d31e221.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The kinematic and physiological pilot study on obstacle properties for young adults with visual and hearing impairments","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eAccording to the World Health Organization (WHO), at least 2.2\u0026nbsp;billion people globally have near or distant vision impairments. Refractive errors and cataracts are the main causes of visual impairment and blindness. The prevalence of visual impairment worldwide is increasing, with 437.5\u0026nbsp;million visually impaired individuals reported in 2019, a 91.5% increase since 1990 \u003csup\u003e1\u003c/sup\u003e. This increase is attributed to the aging population and disparities in access to medical services \u003csup\u003e2\u003c/sup\u003e. Hearing impairment can be caused by congenital factors, infections, noise exposure, aging, and ototoxic drug use. According to WHO reports, approximately 20% of the global population (over 1.5\u0026nbsp;billion people) have some form of hearing impairment, with 430\u0026nbsp;million experiencing impairments severe enough to affect daily life. Preventable causes of hearing impairment are particularly prevalent in low- and middle-income countries, where a significant proportion of affected individuals are children \u003csup\u003e3\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIndividuals with visual and hearing impairments experience restricted physical activity levels and lower quality of life (QOL) owing to the nature of their impairments \u003csup\u003e4,5\u003c/sup\u003e. Furthermore, studies have shown that compared with healthy individuals, those with impairments have poorer physical fitness, including body composition, aerobic capacity, and balance function \u003csup\u003e6,7\u003c/sup\u003e. Additionally, decreased physical activity levels can lead to overactivity of the cardiac sympathetic nervous system, increasing the risk of cardiovascular disease and the incidence of comorbidities \u003csup\u003e8,9\u003c/sup\u003e. However, differences between young individuals with visual and hearing impairments and their healthy counterparts remain unclear. Analyzing autonomic nervous activity (HRV) through orthostatic tolerance tests provides a non-invasive and straightforward method to investigate differences based on impairment characteristics. Therefore, this study aimed to examine the differences arising from the characteristics of visual and hearing impairment in healthy individuals using orthostatic tolerance tests based on HRV frequency domain analysis. Additionally, this study included a physiokinetic analysis of arteriosclerosis indicators, QOL, and physical motor functions.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA recent observational study included 34 university students aged \u0026gt; 20 years who did not engage in regular exercise and attended public facilities in Tsukuba City, Japan, between\u0026nbsp;June\u0026nbsp;2019 and January 2023 (Fig. 1). The participants were divided into three groups\u0026nbsp;(Table.1): the Healthy adult group (H group), consisting of 11 healthy individuals with no visual or hearing impairment; the Visual impairment group (VI group), consisting of 10 individuals with visual impairment (corrected visual acuity in both eyes below approximately 0.3); and the Hearing impairment group (HI group), consisting of 13 individuals with hearing impairment (hearing level in both ears above approximately 60 dB).\u0026nbsp;Measurements were taken for limb muscle mass, body fat percentage, upper- and lower-limb muscle strength, balance ability, cardiac autonomic function, degree of arteriosclerosis, physical activity level, and QOL were measured. Each parameter was compared and analyzed among the groups. The exclusion criteria included individuals with acute coronary syndrome, such as unstable angina and musculoskeletal disorders under medical management, and those whom a physician deemed unsuitable for participation in this study based on medical evidence.\u0026nbsp;The Ethics Committee of Tsukuba University of Technology approved the study protocol (approval number: 2019-02). The study was registered in the University Hospital Medical Network Clinical Trials Registry (Identifier UMIN000054763).\u0026nbsp;This study was conducted in accordance with the principles of the Declaration of Helsinki. All the participants provided written informed consent to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a cross-sectional study. We selected 34 participants who volunteered via poster announcements at our university and associated facilities and provided written consent to participate. Measurements included limb muscle mass, body fat percentage, upper and lower limb strength, balance ability, cardiac autonomic function, arterial stiffness, physical activity level, and Quality of Life (QOL). These parameters were compared between the groups.\u003c/p\u003e\n\u003cp\u003eAll participants were evaluated for physical exercise functionality, and a range of biochemical tests and QOL were compared. A Quality-of-Life assessment was conducted using a questionnaire survey (SF-8) along with body composition analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy procedures.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study design is illustrated in (Figure 2). First, the participants underwent an orthostatic tolerance test after a 15-minute rest period. The orthostatic tolerance test was conducted as follows: the participants sat quietly for 2 min, stood up, and remained standing for another 2 min\u0026nbsp;\u003csup\u003e10\u003c/sup\u003e. The laboratory temperature was maintained at 23\u0026deg;C. All the experiments were conducted during the same time (between 8:00 AM and 1:30 PM). The participants were instructed to refrain from vigorous exercise, eating, or consuming caffeinated beverages for 3 h before the experiment. Additionally, the participants were prohibited from consuming alcohol for 48 h prior to the experiment. Subsequently, measurements were taken for limb muscle mass, body fat percentage, upper- and lower-limb muscle strength, balance ability, cardiac autonomic function, degree of arteriosclerosis, physical activity level, and QOL were measured. Differences in each parameter were compared and analyzed among the groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was calculated using G*Power (Heinrich-Heine University, D\u0026uuml;sseldorf, North Rhine-Westphalia, Germany). The number of study participants was based on a previous study in which HRV analysis was performed on university students with hearing loss [9,10].\u0026nbsp;Therefore,\u0026nbsp;the target number of patients was 34 (\u0026alpha;\u0026nbsp;= 0.05, 1-\u0026beta;\u0026nbsp;＝\u0026nbsp;0.95).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurement of Heart Rate, Blood Pressure, and Autonomic Nervous System Activity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate variability (HRV) indices, which indicate autonomic nervous system activity, were measured during orthostatic tolerance tests conducted before and after each session. Heart rate (HR) was measured using an electrocardiogram (ECG), and BP was measured using an automatic upper-arm blood pressure monitor. HRV indices were measured using the software program \u0026quot;Kiritsu-Meijin\u0026quot; (Crosswell, Yokohama, Japan) to evaluate autonomic reflexes during the orthostatic tolerance test\u003csup\u003e10\u003c/sup\u003e. The R-wave signals from the ECG were acquired at 1000 Hz, with arrhythmias and artifacts automatically detected and removed using the software. All ECG waveforms were stored in the software to ensure the accuracy of the preprocessed data. HRV indices were obtained from HR using modulus electromyography (MEM). MEM does not depend on stationary data and can evaluate autonomic nervous activity based on short-term R-R intervals, making it useful for assessing dynamic or phase changes in autonomic function during and after exercise\u0026nbsp;\u003csup\u003e11-13\u003c/sup\u003e. The software provides reliable HRV analysis at intervals of at least 30 s. The average values for 1 min immediately before and after standing were used as seated values. The coefficient of variation (CVRR) of the R-R intervals was determined by dividing the standard deviation (SD) of the R-R interval by the mean (M) R-R interval. CVRR is used as an indicator of overall autonomic nervous system activity\u0026nbsp;\u003csup\u003e14\u003c/sup\u003e. Frequency analysis was used to extract HF and LF\u0026nbsp;\u003csup\u003e15\u003c/sup\u003e. HF is an indicator of parasympathetic activity, and the ratio of LF to HF (L/H) is an indicator of sympathetic activity\u0026nbsp;\u003csup\u003e16-18\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurement of\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;body composition, degree of arteriosclerosis, Physical activity levels, QOL\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Limb muscle mass and body fat percentage were measured using a body composition analyzer (Tanita Corporation MC-780A). Weight, skeletal muscle mass, and fat mass were measured. Additionally, height and physical activity data were obtained from their application forms\u0026nbsp;\u003csup\u003e19\u003c/sup\u003e. Lower-limb muscle strength, balance, and explosiveness were assessed using a physical function analysis device (ZaRitz BM-220)\u0026nbsp;\u003csup\u003e20\u003c/sup\u003e. The degree of arteriosclerosis was measured using an arteriosclerosis measuring device (NAS-1000, Nihon Kohden Corporation), which is a type of blood pressure monitor that automatically calculates the stiffness of the brachial artery and the degree of arteriosclerosis throughout the body\u0026nbsp;\u003csup\u003e21\u003c/sup\u003e. Physical activity levels were obtained through interviews, and QOL was measured using a questionnaire survey (SF-8)\u0026nbsp;\u003csup\u003e22,23\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData are expressed as means and standard deviation (SD). Statistical analyses were performed using SPSS software (version\u0026nbsp;21.0; SPSS Inc., Chicago, IL, USA). Data were evaluated using a two-way analysis of variance (ANOVA; session \u0026times; time) with post hoc analysis employing a Student\u0026rsquo;s paired t-test between the pre- and post-intervention and between the sitting and standing positions, and a Bonferroni correction for multiple comparisons among the groups. The correlation between each HRV parameter and the API and AVI parameters was determined using Pearson\u0026apos;s correlation coefficient. Statistical significance was accepted when the p-values were \u0026lt;\u0026nbsp; 0.05.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eNo falls or adverse events occurred during the measurement procedures, indicating that the assessments were performed safely. The characteristics of the participants are summarized in Table 1. As shown in Figure 3, no significant differences were observed among the three groups in either PCS or MCS, which are indicators of QOL. There were no significant differences in HR, SBP, or DBP before and after the orthostatic tolerance test, nor were there any differences among the three groups (Table 2). In Figure 4, Graph (A) shows that the HR significantly changed when standing up among the three groups (P = 0.015). Furthermore, a significant difference was observed between the H group and HI group (P = 0.003). Graph (B) shows that the SBP did not change when standing among the three groups or when standing from the sitting position in all groups. In Figure 5, Graph (A) shows that CVRR significantly changed in the sitting position before and after the orthostatic tolerance test (P = 0.0178). Furthermore, a significant difference was observed between the VI group and HI group (P = 0.0265). Graph (B) shows that HF significantly changed in the sitting position before and after the orthostatic tolerance test between the H group and HI group and between the HI and VI groups (P = 0.0004). Graph (C) shows that L/H did not change before and after the orthostatic tolerance test or among the three groups. As shown in Figure 6, the results of the API measurements indicate that the standard value for the API is between 20 and 33. The average value for the HI group exceeded the standard range. A significant difference was observed between the H group and HI group (P = 0.013). The results of the AVI measurements indicated that the standard value for AVI was between 17 and 31. The average value for the HI group exceeded the standard range. A significant difference was observed between the H group and HI group (P = 0.045). No differences were observed among the three groups in terms of muscle strength, balance, or chair speed.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In Figure 7, Graph (A) shows a significant correlation between CVRR and API in the VI group (r = -0.64; p = 0.04). Graph (B) shows a significant correlation between L/H and API (r = 0.57, p = 0.04). No differences were observed among the three groups in terms of muscle strength, balance, or chair speed.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThis study is the first to investigate the physiokinetic characteristics and health risks in young individuals with visual and hearing impairments. Our findings indicate that while there are no significant differences in quality of life (QOL), body composition, or physical motor function between healthy individuals and those with visual or hearing impairments, distinct differences are observed in heart rate variability (HRV) and arteriosclerosis indicators obtained from the orthostatic tolerance test.\u003c/p\u003e \u003cp\u003eThe hypothesis that HRV is involved in arteriosclerosis and reflects differences in impairment at an early stage is supported by our results. Physical activity typically activates the sympathetic nervous system and inhibits parasympathetic activity\u003csup\u003e24,25\u003c/sup\u003e, which aligns with the findings in the healthy (H) and visually impaired (VI) groups. However, the hearing impaired (HI) group, shielded from noise, shows activation of parasympathetic nervous system activity even at rest\u003csup\u003e26\u003c/sup\u003e. This unique response likely contributes to the observed differences in arteriosclerosis indicators between the groups. The HI group's atherosclerosis index exceeding the standard value suggests that atherosclerosis progresses before any change in blood pressure\u003csup\u003e27,28\u003c/sup\u003e, highlighting the need for early interventions.\u003c/p\u003e \u003cp\u003ePrevious studies have noted that elderly individuals with sensory impairments tend to have lower physical activity levels, decreased physical motor function, and reduced QOL\u003csup\u003e29\u003c/sup\u003e, which are associated with a higher risk of lifestyle-related diseases such as arteriosclerosis\u003csup\u003e30\u003c/sup\u003e. Our study extends these findings to younger populations, suggesting that in environments where disability support is provided\u003csup\u003e31\u003c/sup\u003e, physical activity levels can be maintained, resulting in physical function and body composition comparable to healthy individuals of the same age. Consequently, no significant differences in QOL were observed among the groups.\u003c/p\u003e \u003cp\u003eThis study has some limitations. First, the sample size was limited to a single-center analysis. Second, participants did not undergo any intervention, which limits the ability to draw causal conclusions. Future studies should aim to include a larger sample size and extend the intervention period to validate these findings and explore the potential benefits of tailored preventive health programs for individuals with visual and hearing impairments.\u003c/p\u003e \u003cp\u003eIn conclusion, despite the small sample size, this study provides valuable insights into the physical function, body composition, and cardiac autonomic function of visually impaired, hearing impaired, and healthy young individuals. The results underscore the importance of early and tailored preventive rehabilitation based on specific disability characteristics to mitigate health risks and enhance social participation through increased physical activity.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eDespite the small sample size, this is the first study to investigate physical function, body composition, and cardiac autonomic function among visually impaired, hearing-impaired, and healthy cohorts. These results hold value beyond the prevention of diseases and care requirements for the visually and hearing-impaired and present substantial benefits for the social participation of disabled individuals through increased physical activity. This study highlights the potential effectiveness of tailored preventive rehabilitation based on specific disability characteristics.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eSupporting Information\u003c/h2\u003e \u003cp\u003eS1 table. Absolute and normalized values of HRV indices in the sitting position\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eInstitutional Review Board Statement\u003c/h2\u003e \u003cp\u003e The Ethics Committee of Tsukuba University of Technology approved the study protocol (approval number: 2019-02). The study was registered in the University Hospital Medical Network Clinical Trials Registry (Identifier UMIN000054763).\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eInformed consent\u003c/h2\u003e \u003cp\u003ewas obtained from all subjects involved in the study.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eConflicts of Interest\u003c/h2\u003e \u003cp\u003eAll authors have no conflicts of interest to disclose.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eMisa Miura is currently receiving grants (21K11189, 23H03249) from JSPS KAKENHI.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eMM. and GH.; data curation, HM.; HT.; measurement, HS.; health management, HT.; supervision, MM.; writing and editing, KM.; supervision.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors thank all the participants who volunteered for this study. The authors also thank Li Jie for technical assistance.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript or supplementary information files．\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. The Lancet. Global health. 9, e144-e160 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSteinmetz, J. D. \u003cem\u003eet al.\u003c/em\u003e Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. The Lancet Global Health. 9, e144-e160 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaile, L. M. \u003cem\u003eet al.\u003c/em\u003e Hearing loss prevalence and years lived with disability, 1990\u0026ndash;2019: findings from the Global Burden of Disease Study 2019. The Lancet. 397, 996\u0026ndash;1009 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang, K. F. \u003cem\u003eet al.\u003c/em\u003e Influence of visual impairment and hearing impairment on functional dependence status among people in Taiwan-An evaluation using the WHODAS 2.0 score. Journal of the Chinese Medical Association: JCMA. 81, 376\u0026ndash;382 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTurunen-Taheri, S., Skagerstrand, \u0026Aring;., Hellstr\u0026ouml;m, S. \u0026amp; Carlsson, P. I. Patients with severe-to-profound hearing impairment and simultaneous severe vision impairment: a quality-of-life study. Acta oto-laryngologica. 137, 279\u0026ndash;285 (2017).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHill-Briggs, F., Dial, J. G., Morere, D. A. \u0026amp; Joyce, A. Neuropsychological assessment of persons with physical disability, visual impairment or blindness, and hearing impairment or deafness. Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists. 22, 389\u0026ndash;404 (2007).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang, J. R. \u003cem\u003eet al.\u003c/em\u003e Body mass index, waist circumference, and risk of hearing loss: a meta-analysis and systematic review of observational study. Environmental health and preventive medicine. 25, 25 (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTan, H. E. \u003cem\u003eet al.\u003c/em\u003e Associations between cardiovascular disease and its risk factors with hearing loss-A cross-sectional analysis. \u003cem\u003eClinical otolaryngology: official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology \u0026amp; Cervico-Facial Surgery\u003c/em\u003e. 43, 172\u0026ndash;181 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFisher, D. \u003cem\u003eet al.\u003c/em\u003e Impairments in hearing and vision impact on mortality in older people: the AGES-Reykjavik Study. Age and ageing. 43, 69\u0026ndash;76 (2014).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJia, T., Ogawa, Y., Miura, M., Ito, O. \u0026amp; Kohzuki, M. Music Attenuated a Decrease in Parasympathetic Nervous System Activity after Exercise. PloS one. 11, e0148648 (2016).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMacor, F., Fagard, R. \u0026amp; Amery, A. 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Journal of Postsecondary Education and Disability. 28, 421\u0026ndash;431 (2015).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 and 2 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"visual impairment, hearing impairment, orthostatic tolerance test, kinematic and physiological analysis, preventive medicine","lastPublishedDoi":"10.21203/rs.3.rs-4787024/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4787024/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIndividuals with visual and hearing impairments often experience a lower quality of life (QOL) and reduced physical motor functions due to restricted activity ranges. This reduction in physical activity can lead to overactivity of cardiac sympathetic nerves, increasing the risk of cardiovascular disease. However, the specific differences in physiological and kinematic responses due to the characteristics of visual and hearing impairments remain unclear.\u003c/p\u003e \u003cp\u003eThis pilot study aimed to investigate these differences in 34 university students using an orthostatic tolerance test and to analyze various parameters, including indicators of arteriosclerosis and physical motor functions. Participants were divided into three groups: healthy individuals, individuals with visual impairments, and individuals with hearing impairments.\u003c/p\u003e \u003cp\u003eThe results showed no significant differences in QOL and physical motor abilities between healthy and impaired individuals. However, distinct differences were observed in the orthostatic tolerance test based on the type of impairment. Associations between autonomic nervous system parameters and arteriosclerosis indicators were also identified in individuals with visual or hearing impairments.\u003c/p\u003e \u003cp\u003eThese findings highlight the necessity of addressing health risks specific to the type of impairment from a young age, suggesting the potential benefits of tailored preventive health programs.\u003c/p\u003e","manuscriptTitle":"The kinematic and physiological pilot study on obstacle properties for young adults with visual and hearing impairments","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-02 19:17:39","doi":"10.21203/rs.3.rs-4787024/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95b5b10c-bb9c-4aef-b1a7-7f777487a956","owner":[],"postedDate":"September 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":36471751,"name":"Health sciences/Health care"},{"id":36471752,"name":"Health sciences/Medical research"},{"id":36471753,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2025-12-29T17:19:02+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-02 19:17:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4787024","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4787024","identity":"rs-4787024","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}